8823 HOLLY DR 504 BLDG P 2021-12-17

• ,/--# ,A.-„,/---- -:,-,. LLECT flC L PERMIT A JCCATION ' �`milaCITY OF EVERETT PERMIT SERVICES J 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-88571 (E) everetteps@everettwa.gov j www.everettwa.gov/permits P'*JECT SITE II Fa= iATIOO >: . PROJECT ADDRESS: (68 `)• `2) \k& " Y .9 YL, ti_ 1 `j U BUILDING AREA(if residential,new construction,remodel,or addition) SF - BUILDiNG TYPEEFR-DETACHED 0 SFR-ATTACHED 0 DUPL ❑MULTi-FAMI -#OF UNITS: 0 COMMERCIAL USE OF BUILDING: igLECTRICAL APPiICA 01 9NFORM0110:4 CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage):• FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): • DESCRIPTION OF WORK: (-)'-e Yv--( ,r- r0-'v-C1,--1 \ °A 6' .(-n,— \on_ ')-rJ--•w, C®NTACT,INFORNfATION.-,.:: OWNER NAME: nr Arc_c‘_,,` cr e_' - TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET \j 04-1_ \ j A 9 e�D- wry 7,;-CT 0- - STATE ,Ok.r—tt ZIP Y (��Q(? OWNER PHONE: OWNER EMAIL:....N.. l CONTRACTOR NAME: 004-11e'Y CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAiL: • CONTRACTOR LiC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT:MCI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That lam authorized by the owner of this properly to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# o s � ` �� E ! &®cxO1w Owner/Authorized Age ignature Date (Revised 90/92/2095)